If you’re sexually active, the best way to protect yourself against HIV infection is to use a condom. Condoms have lots going for them – they are cheap, ubiquitous and have been accepted by men and women as an effective measure against both infection and conception for decades. So fundamental to sexual health is the humble condom they’ve not changed much since the first latex condom was introduced in the 1920s. (Although that’s set to change as Bill and Melinda Gates Foundation have put out the call for proposals to develop the next generation condom for substantial grant funding, as part of their Grand Challenge Explorations.)
But for all their many benefits, condoms have one fundamental failing.
They don’t protect women.
And they don’t protect the women who need protection the most – young women and girls.
They don’t protect women NOT because they don’t work, they do, but because women don’t have the power to insist on using a condom each and every time they have sex.
Women are more susceptible to HIV than men are. Biologically they are vulnerable. Herpes infection – more common in women than men – increases susceptibility to infection. Young women especially may have tears from sex that give the virus ready access to their bloodstream. They are more likely to be subject to domestic violence, or coerced into sex – making the use of a condom about as realistic as hot running water in the bush. And for many women, married life leaves them subject to their husband’s will, without control of their own bodies and feeling they don’t have the right to deny their husband sex. With that kind of power difference, initiating a sensitive and assertive negotiation to insist on using a condom, goes right out of the window.
Condoms remain the bedrock of most HIV prevention strategies, but from a woman’s perspective, they might as well be used as a wrapper for bananas.
Women need protection they have control over. Protection they can use regardless of the preferences or opinion of their partner. Something easy and cheap to use that doesn’t get in the way, feel odd to their partner, smell, make a noise or otherwise give the game away. Something simple, easy and effective that they can use discretely and consistently throughout their sexually active lives.
Remarkably, this technology is now within their reach. Microbicides, effective against the HIV virus have been developed alongside new antiretrovirals. These microbicides break the virus’ DNA on contact. Gels, films, and pessaries have been developed, but while these do potentially give women back control, they don’t overcome the challenge of giving easy, undetectable, continuous protection.
Recognising the pressing need to address the unequal burden of HIV infection between men and women, especially the vulnerability of young women to unprotected sex, the International Partnership on Microbicides (IPM) have been working with Janssen Pharmaceuticals to bring a new microbicide technology to market – the vaginal ring.
IPM’s long-acting dapivirine vaginal ring will give women with an easy to use, practical way they have control over, to protect themselves against HIV for a month at a time.
- IPM studies show the ring is highly acceptable to women in Africa, where the need is most urgent
- The ring is physically stable, durable and easy to distribute, making it suitable for use in developing countries
- The ring delivers the ARV locally where it’s needed, with low systemic drug absorption
The monthly ring, which slowly releases the ARV drug dapivirine over time to protect against HIV, is currently in two Phase III trials, with efficacy results expected as soon as early 2016. You can read more about the ring on IPM’s website here.
In preparation for taking this important and innovative preventive technology to market, IPM asked Baird’s CMC to support their ground breaking work with stakeholder mapping across four African nations. This study will provide essential information to establish working relationships with policy makers, regulators, distributors, civil society groups and health service providers in readiness for the introduction of the dapivirine ring.
At Baird’s CMC we know this technology is desperately needed by women and will be a game changer in HIV prevention. By leveraging our national and local networks of expertise across Africa we are reaching the decision makers and influencers IPM most need to reach. By delivering the insight and intelligence IPM need, we’ll prepare them for approvals and give this new, innovative technology the best chance of being accepted and promoted by decision makers and ultimately, getting it to the women who need it.